February 2014

What the New Cholesterol Guidelines Mean for You

Late last year, the American Heart Association and the American College of Cardiology issued new guidelines for treating high cholesterol. Their goal: to reduce heart disease and stroke. Here are key points you should know.

The importance of a healthy lifestyle

Your body naturally creates a small amount of cholesterol, which is all you need. This fat-like substance aids in hormone production and digestion. But your cholesterol can climb to unhealthy levels because it's also found in many of the foods you eat. That can put you at risk for heart disease.

As a result, heart experts still emphasize the importance of a healthy lifestyle in controlling cholesterol levels. In the guidelines, they recommend:

Eating a heart-healthy diet

Not smoking

Getting regular exercise

Maintaining a healthy weight

These 4 steps may be combined with cholesterol-lowering medication, if needed.

Statins benefit certain groups

Statins are a type of medicine that helps lower cholesterol levels. When prescribing statins, doctors have typically used target levels for LDL (bad) and HDL (good) cholesterol. After reviewing numerous studies on statin use, heart experts are no longer focusing solely on the numbers. Instead, the new guidelines recommend statins for those who would benefit most. Specifically, that includes the following 4 groups:

People with heart disease

People with high LDL levels—above 190 mg/dL

People ages 40 to 75 with diabetes with an LDL of 70 to 189 mg/dL

People ages 40 to 75 who don't have diabetes and who have a 7.5% or higher risk for heart problems in the next 10 years and an LDL of 70 to 189 mg/dL

If you don’t fall into one of these categories, your doctor may still recommend a statin. You may benefit from one based on your family history, health status, and other factors. But statins can cause some serious side effects, so be sure to discuss the risks and benefits of statin drugs with your doctor before starting to take one.

More accurate risk assessment

In compiling the guidelines, heart experts also developed a new tool to assess a person’s 10-year and lifetime risk for heart-related problems. The risk calculator now provides more accurate information, especially for ethnic groups such as African Americans. It also factors in your risk for stroke.

To use the calculator, your doctor will need your age, sex, race, smoking status, and cholesterol and blood pressure levels. The assessment also takes into account whether you have diabetes. With the results, you and your doctor can have a more detailed discussion about how best to control cholesterol levels.

The bottom line

From 1999 to 2010, the number of Americans with high cholesterol dropped 27%. Despite this considerable decline, the latest statistics suggest this trend is stalling. Screening rates also remain unchanged.

Heart experts hope the new guidelines will lower heart disease and stroke nationwide. But the guidelines aren’t a hard-and-fast rule to better heart health. Plus, ongoing research may one day change them. For now, you can do your part by first talking with your doctor about a risk assessment. Then take the necessary steps to improve your health.